| NPI | 1841649845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IL 036148211) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036148211) |
| 207Q00000X Family Medicine (Licence: IL 125068221) | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2026-08-24 |